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It’s Complicated: Long-Term Treatment for Chronic GERD

by
the MWHC Blog Team
November 29, 2016

It’s Complicated: Long-Term Treatment for Chronic GERD

Nearly 20 percent of Americans suffer from regular bouts of heartburn, acid indigestion and other symptoms of chronic gastroesophageal reflux disease (GERD). A fortunate few find relief through lifestyle modifications such as losing weight, avoiding certain foods, elevating the head of the bed and not eating within three hours of going to sleep, among others. But many more must turn to medication to tame that burning, painful sensation.

For the last two decades, the most popular and effective GERD medicine on the market, both prescription and over-the-counter, has been a class of drugs called proton pump inhibitors (PPIs).

“The original PPI was first approved in the United States in 1989 for the short-term treatment of ulcers,” explains Timothy Koch, MD, a gastroenterologist and bariatric specialist at MedStar Washington Hospital Center. “When doctors saw how well it worked on the symptoms of ulcers, they started to wonder if PPIs would be effective for persistent heartburn, as well.”

As everyone now knows, the answer was a resounding “yes.” But more recently, scientists have been asking, “For how long?”

“Over the last few years, there have been many studies looking at whether long-term PPI use contributes to gut infections, bone loss, chronic kidney disease and even dementia,” Dr. Koch says. “While findings suggest an association, we don’t have any definitive answers yet.”

Untreated GERD can damage the food pipe, and contribute to Barrett’s esophagus, a risk factor for esophageal cancer, so it’s important not to ignore.

“Through endoscopy and other specialized studies we can look for scar tissue and other irritation, measure problems with swallowing, and otherwise evaluate each patient to see if there is another cause of their discomfort…and possibly an alternative to long-term PPI treatment,” he adds.

As a precaution, Dr. Koch recommends that people who have been taking more than one PPI a day for many years seek a thorough medical re-evaluation to see if they still need—and are benefitting from— the medication.